血液透析患者中万古霉素检测方法的比较。

IF 3 4区 医学 Q2 INFECTIOUS DISEASES Brazilian Journal of Infectious Diseases Pub Date : 2024-09-01 DOI:10.1016/j.bjid.2024.103869
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引用次数: 0

摘要

万古霉素是一种糖肽类抗生素,主要通过肾小球滤过排泄。因此,接受血液透析的患者体内往往会积聚万古霉素的结晶降解产物,这与商用免疫测定的交叉反应有关。本研究旨在评估两种商用免疫测定法在测量血液透析患者体内万古霉素水平时的性能。这项方法比较研究招募了巴西阿雷格里港两家医院的血液透析患者。通过化学发光微粒子测定法(CMIA)和溶液中微粒子动力学相互作用法(KIMS)测定的万古霉素血清浓度与液相色谱-串联质谱法(LC-MS/MS)进行了比较。CMIA 组和 KIMS 组分别包括 42 名患者的 64 份样本和 23 名患者的 54 份样本。这两项测量结果与 LC-MS/MS 高度相关,斯皮尔曼秩相关系数分别为 r = 0.840 (p < 0.001) 和 r = 0.926 (p < 0.001)。未观察到线性偏差(分别为 p = 0.81 和 p = 0.49)。CMIA 与 LC-MS/MS 之间的平均差异为-1.19 μg/mL,KIMS 与 LC-MS/MS 之间的平均差异为-2.28 μg/mL。LC-MS/MS 测得的水平平均比 CMIA 高 2.64%,比 KIMS 高 8.81%。CMIA 和 KIMS 是测量血液透析患者万古霉素血清浓度的准确商业方法。
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Comparison of vancomycin assays in patients undergoing hemodialysis
Vancomycin is a glycopeptide antibiotic mainly excreted by glomerular filtration. Therefore, patients undergoing hemodialysis tend to accumulate its crystalline degradation product, which has been associated with cross-reaction in commercial immunoassays. The aim of this study was to assess the performance of two commercial immunoassays for measuring vancomycin levels in patients undergoing hemodialysis. This method-comparison study enrolled patients undergoing hemodialysis at two hospitals in Porto Alegre, Brazil. Vancomycin serum concentrations measured by Chemiluminescent Microparticle Assay (CMIA) and measured by Kinetic Interaction of Microparticles in Solution (KIMS) were compared with Liquid Chromatography coupled with Tandem Mass Spectrometry (LC-MS/MS). A total of 64 samples from 42 patients and 54 samples from 23 patients were included in CMIA and KIMS groups. Both measurements were highly correlated with LC-MS/MS, with Spearman rank correlation coefficient r = 0.840 (p < 0.001) and r = 0.926 (p < 0.001), respectively. No deviation of linearity was observed (p = 0.81 and p = 0.49, respectively). The mean difference between CMIA and LC-MS/MS was -1.19 μg/mL and between KIMS and LC-MS/MS was -2.28 μg/mL. LC-MS/MS measured levels were, on average, 2.64 % higher than CMIA and 8.81 % higher than KIMS. CMIA and KIMS revealed accurate commercial methods to measure vancomycin serum concentrations in patients undergoing hemodialysis.
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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
925
审稿时长
41 days
期刊介绍: The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents. The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor, since its inception it has garnered a growing share of the publishing market.
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